Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A29416 | CA |
NPI | 1285691121 |
---|---|
Provider Name | Dr. Dionisio A. Fernandes |
First Address | Fremont, CA 94538-1422 |
Second Address | San Leandro, CA 94578 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 25/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A25751 | (02) | CA |
GR0066330 | (05) | CA |
GR0066331 | (05) | CA |